Field of the Invention
The invention relates to an apparatus for placing a feeding tube in the stomach of a human or animal body.
In the case of patients with whom feeding through the oesophagus is not possible, for example as a result of dysphagia after apoplexy or in the case of an oesophageal tumour, feeding can take place by way of a so-called fistula which leads straight into the stomach from the abdominal surface. The present invention is concerned with the improvement of such devices.
Description of the Prior Art
Earlier, such fistulae were established by the surgeon operatively (gastric fistula); nowadays, they can be placed in the form of feeding tubes, more simply, endoscopically. In this connection, the procedure is as follows:
A flexible gastroscope is introduced into the stomach and, under endoscopic control, a hollow needle, upon which a plastic sleeve is arranged, is inserted into the stomach from outside. The hollow needle is subsequently drawn out of the sleeve whilst the sleeve remains in the puncture.
The next step consists in introducing a thread through the sleeve into the stomach, which thread is then gripped from the inside by means of a gripping tool, introduced by way of the endoscopic instrumentation channel, and is drawn out of the body, in which case it is necessary to draw out the gastroscope as well in order to be able to draw the free end of the thread out of the instrumentation channel. This extracorporeal end of the thread is then secured to the tip of the feeding tube outside the body of the patient.
By drawing the end of the thread on the fistula side, the tube is then drawn by way of the mouth and the oesophagus, in the first instance, into the stomach and then into the puncture, in which case the sleeve is drawn, or pushed, at the same time out of the stomach wall and the abdominal wall. The end position of the tube is defined by an annular limiting part on its periphery, owing to the fact that the limiting part reaches the inner wall of the stomach and thus prevents the tube from being drawn through. After the thread has been detached from the now protruding end of the tube and this end has been cut to a desired length, feeding can take place through the tube. The fixing of this tube end may be achieved by means of a plaster.
This known apparatus requires considerable input, in terms of treatment and time, for placing the tube. This is largely because the connection between the thread and the tube can only be produced outside the body, and thus, as described previously, the withdrawal of the thread by means of the gastroscope is necessary.